Iglezias Silvia D'Andretta, Abreu Patrícia Antonia Estima, Kanamura Cristina, Magaldi Antonio José, Seguro Antonio Carlos, Brito Thales De
Instituto Adolfo Lutz, Laboratório de Patologia, São Paulo, São Paulo, Brazil.
Instituto Butantan, Laboratório de Bacteriologia, São Paulo, São Paulo, Brazil.
Rev Inst Med Trop Sao Paulo. 2020 Nov 9;62:e85. doi: 10.1590/S1678-9946202062085. eCollection 2020.
Leptospirosis is an acute infection caused by pathogenic species of the genus Leptospira, which affects humans and animals in all world. In severe forms of the disease, kidneys, liver and lungs are the main affected organs, resulting in acute kidney injury, jaundice and pulmonary hemorrhage. Previous post-mortem studies have shown that lesions are not limited to these organs. Cardiac and striated muscle injuries have already been reported, but the pathophysiology of cardiac and skeletal lesions in leptospirosis is not fully understood. It has been suggested that the tissue damage observed in leptospirosis could be directly mediated by leptospires or by their toxic cellular components. LipL32 and Lp25 are leptospira membrane proteins with unknown functions, that are present only in pathogenic strains of Leptospira spp. Both proteins induce skeletal muscle lesions similar to those observed when normal guinea pigs are inoculated with leptospires. Through immunohistochemistry, this study showed the presence of LipL32 and Lp25 proteins on muscle cell membranes and in the underlying cytoplasm of skeletal muscles, as well as focal lesions in cardiac tissues of fatal cases of leptospirosis. Altogether, these results reinforce that both proteins can be important factors in the pathogenesis of leptospirosis.
钩端螺旋体病是由钩端螺旋体属的致病菌种引起的急性感染,影响着全球的人类和动物。在该病的严重形式中,肾脏、肝脏和肺是主要受影响的器官,会导致急性肾损伤、黄疸和肺出血。先前的尸检研究表明,病变并不局限于这些器官。心脏和横纹肌损伤已有报道,但钩端螺旋体病中心脏和骨骼病变的病理生理学尚未完全了解。有人提出,在钩端螺旋体病中观察到的组织损伤可能直接由钩端螺旋体或其毒性细胞成分介导。LipL32和Lp25是功能未知的钩端螺旋体膜蛋白,仅存在于钩端螺旋体属的致病菌株中。这两种蛋白都会诱导与正常豚鼠接种钩端螺旋体时观察到的类似骨骼肌病变。通过免疫组织化学,本研究显示LipL32和Lp25蛋白存在于骨骼肌细胞膜及其下方的细胞质中,以及钩端螺旋体病致死病例的心脏组织中的局灶性病变。总之,这些结果强化了这两种蛋白可能是钩端螺旋体病发病机制中的重要因素。